Every year has been transformative throughout the past decade that I have served on The Miriam Hospital Board, and this year was no exception. A few years ago, we merged Miriam and Rhode Island hospital boards for better alignment, and as a Rhode Island Hospital Trustee I have learned even more about the challenges of governing a large health care system in today’s turbulent climate. This year, the new board chair and CEO decided to consolidate LifeSpan’s five boards into one to be more integrated, competitive and nimble. For many of us, that meant resigning our board seat. It also meant letting go of our concerns that the centralized structure would be detrimental to the individual hospitals. We came to appreciate that our focus had to be the greater good. This change challenged me to “walk the walk” since I often advise boards that they need to adapt to change and serve community interests rather than protect institutions. Kudos to LifeSpan for delicately maneuvering this charged consolidation. As Vice Chair of the Miriam Hospital Quality committee, I know that change is the one constant.